A 26-year-old man is brought by law enforcement to the inpatient psychiatric hospital after threatening his neighbors. The patient tells the PMHNP that everyone in his neighborhood is conspiring against him by installing cameras on their doorbells to watch his every move. He states, "These men are government agents sent to shut me up." Which of the following medications/treatments would be most appropriate at this time?
Electroconvulsive therapy (ECT)
Alprazolam (Xanax)
Fluoxetine (Prozac)
Ziprasidone (Geodon)
The Correct Answer is D
Choice A reason: Electroconvulsive therapy is typically reserved for severe depression, catatonia, or treatment-resistant mood disorders. It is not first-line for acute psychosis, especially in a young adult with paranoid delusions.
Choice B reason: Alprazolam is a benzodiazepine used for anxiety and panic disorders. It is not appropriate for treating psychosis and may worsen disinhibition or aggression in psychotic patients.
Choice C reason: Fluoxetine is an SSRI used for depression and anxiety disorders. It does not address the core symptoms of schizophrenia or acute psychosis, such as delusions and paranoia.
Choice D reason: Ziprasidone is an atypical antipsychotic effective in treating schizophrenia and acute psychotic episodes. It targets dopamine and serotonin receptors, helping to reduce delusions, hallucinations, and agitation. It is appropriate for managing the patient’s paranoid psychosis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Polysomnography is a comprehensive overnight sleep study used to diagnose sleep disorders such as obstructive sleep apnea, parasomnias, and periodic limb movement disorder. While it provides objective data on sleep architecture and disturbances, it does not specifically distinguish between subjective feelings of fatigue and actual dozing behavior during the day.
Choice B reason: The Multiple Sleep Latency Test (MSLT) is an objective test that measures how quickly a person falls asleep in a quiet environment during the day. It is used to assess excessive daytime sleepiness and diagnose conditions like narcolepsy. However, it does not capture subjective experiences or differentiate between fatigue and sleepiness based on self-report.
Choice C reason: The Epworth Sleepiness Scale is a validated self-administered questionnaire that evaluates the likelihood of dozing off in various daily situations. It is specifically designed to distinguish between general fatigue and actual sleepiness by assessing the propensity to fall asleep, making it the most appropriate tool in this scenario.
Choice D reason: CSF hypocretin measurement is used in the diagnosis of narcolepsy type 1, where hypocretin levels are typically low. While it is a biomarker for a specific sleep disorder, it does not help differentiate between fatigue and sleepiness in broader clinical contexts and is not a practical screening tool for general sleep complaints.
Correct Answer is D
Explanation
Choice A reason: This is correct. When slough or eschar obscures the wound bed, the ulcer is classified as unstageable until the base is visible. Accurate staging requires assessment of tissue depth and type.
Choice B reason: This is correct. Pressure ulcers do not progress through stages as they heal. For example, a stage 4 ulcer does not become a stage 3 ulcer during healing. Instead, it is described as a “healing stage 4 ulcer.”
Choice C reason: This is correct. In individuals with dark skin, early signs of pressure injury may present as persistent discoloration rather than visible redness. Recognizing these variations is essential for early detection.
Choice D reason: This is incorrect. The presence of a pressure ulcer may reflect inadequate care, poor mobility support, or lack of access to services. While not always indicative of neglect, it warrants evaluation of the patient’s support system and care environment.
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